TSH is normal T4 is elevated, T4 is elevated TSH is normal what does this mean, causes, symptoms, treatment

A blood test for hormones allows you to assess the state of the endocrine system by determining the hormonal levels that are created by the pituitary gland and the thyroid gland. An increase or decrease in the value of one of the hormones is an important diagnostic sign.

This article is devoted to the description of cases when one of the hormones is elevated. An increase in the values ​​of both TSH and T4 is discussed in the article T4 and TSH is increased: norms, causes and symptoms of an increase, the principle of treatment.

Normal T4 with elevated TSH

ttg - 7An increase in TSH with normal T3 and T4 is normally observed with heavy loads on the body, during the course of treatment with the appointment of iodine-containing drugs and antipsychotics. Also, the hormone TSH often rises during pregnancy, which does not apply to pathological conditions. When an increased content of hormones is determined and there are indications, treatment begins immediately, since there is a risk of hypothyroidism.

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Factors affecting the increase in TSH with normal T4:

  • dysfunction of the adrenal glands,
  • severe gestosis,
  • violation of hormone secretion,
  • the presence of benign and malignant formations,
  • transfer of psychological trauma.

With a high TSH and normal T3 and T4 levels, an endocrinologist can diagnose subclinical hypothyroidism. In this case, clinical symptoms will be mild or absent altogether. If a disease is suspected, additional blood tests are prescribed.

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Other causes of subclinical hypothyroidism:

  1. insufficient intake of iodine,
  2. a consequence of surgical treatment of the thyroid gland,
  3. reception of radioactive iodine,
  4. drug treatment with thyreostatics.

The concentration of substances increases due to hemodialysis and in case of severe lead poisoning. During pregnancy, the concentration of a substance can change regularly throughout the entire period. It depends on nutrition, level of physical activity and the general condition of the endocrine glands. With a significant increase in TSH levels in the first and second trimester of pregnancy, the doctor may prescribe drug treatment with the appointment of L-thyroxine.

Symptoms and treatment principle

Violation of the TSH level with normal T4 is always accompanied by general symptoms in the form of a deterioration in well-being. Without appropriate treatment, the clinical picture is aggravated, and serious health problems can appear.

Symptoms of an increase in TSH with a normal T4:

  • weakness, fatigue and decreased physical activity,
  • in pregnant women, the neck thickens (thyroid hypertrophy),
  • appetite worsens or is completely absent,
  • the function of the organs of the gastrointestinal tract is disturbed,
  • apathetic state and insomnia appear.

Signs of subclinical hypothyroidism:

  1. dry skin and mucous membranes, hair loss,
  2. slowness and lethargy, inhibited reaction,
  3. dysfunction of the digestive system,
  4. decreased libido,
  5. obesity.

In this case, prevention of the development of hypothyroidism is necessary. Drug treatment is used with the appointment of synthetic T4 free. With subclinical hypothyroidism, treatment with Levothyroxine is indicated.

Elevated T4 with normal TSH

During the year, the T4 level can change, it reaches its maximum concentration in the autumn-winter period. In men, this indicator is normally higher. In the absence of deviations, the concentration of the T4 hormone in people under 40 is stable, varies within normal limits, and changes only in the case of pathological processes.

ttg2 - 9Causes

The causal factors of deviation are divided into two groups. In the first case, there will be pronounced hyperfunction of the thyroid gland and increased production of hormones in the absence of the need for this.

The second group includes factors associated with the destruction of thyroid cells and the release of hormones into the blood. This is possible in the case of autoimmune or postpartum thyroiditis.

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Reasons for high T4 with normal TSH:

  • thyroiditis, toxic goiter,
  • thyrotoxicosis, obesity,
  • kidney pathology, nephrotic syndrome,
  • chronic liver dysfunction,
  • choriocarcinoma.

Treatment with hormonal drugs can increase the concentration of the hormone. This condition is defined as drug thyrotoxicosis. Most often, free thyroxine increases with the development of hyperthyroidism. This phenomenon is considered only a clinical syndrome and is manifested by changes in the patient’s psycho-emotional state.

Symptoms and treatment principle

High T4 manifestations with normal TSH:

  1. deterioration of general well-being in the hot season, sweating,
  2. frequent urge to empty the bowels,
  3. tremors of the arms and legs,
  4. disorders of the cardiovascular system in the form of tachycardia and arrhythmias,
  5. deterioration of the skin condition, fragility and hair loss, lamination of nails,
  6. in women, the menstrual cycle is disturbed, there is a risk of amenorrhea.

Toxic goiter dramatically increases the level of T4 hormone production. At the same time, the symptoms are pronounced and constantly increasing. In chronic autoimmune or postpartum thyroiditis, T4 is destroyed by antibodies, the hormone enters the bloodstream, and so a high level of thyroxine is detected against the background of normal TSH.

ttg8 - 11This disorder can be of varying severity, depending on the concentration of T4 and its relationship with the hormone TSH. With a slight deviation in the level, a mild form of the disorder is diagnosed without manifestation of symptoms.

Moderate severity is defined as overt hyperthyroidism and is diagnosed with an increase in T4 and a decrease in TSH. A severe form is observed when a high T4 is diagnosed with a reduced or normal TSH.

This form of hyperthyroidism has pronounced symptoms and toxic goiter becomes the root cause.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.